Achilles' tendon
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The Achilles' tendon or heel (tendo Achillis) or the calcaneal tendon (tendo calcaneus) is a tendon of the posterior leg. It serves to attach the gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone.
Achilles' heel is also a common expression for the single vulnerable spot in something or someone (in reference to the Achilles story from Greek Mythology).
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Anatomy
In humans it passes behind the ankle. It is the thickest and strongest tendon in the body. It is about 15 cm long, and begins near the middle of the leg, but receives fleshy fibers on its anterior surface, almost to its lower end. Gradually becoming contracted below, it is inserted into the middle part of the posterior surface of the calcaneus, a bursa being interposed between the tendon and the upper part of this surface. The tendon spreads out somewhat at its lower end, so that its narrowest part is about 4 cm. above its insertion. It is covered by the fascia and the integument, and stands out prominently behind the bone; the gap is filled up with areolar and adipose tissue. Along its lateral side, but superficial to it, is the small saphenous vein.
Nomenclature
The tendon gets its more common name from a myth about the hero Achilles, from Greek mythology. His mother Thetis decided to make him invulnerable, so she dipped him as a baby into the river Styx, whose waters had the power to do this. However, she held the baby by his heel and forgot to immerse that too, leaving that as his only vulnerable spot. He was later killed during the Trojan War by an arrow directed at his heel by Paris. This legend came to be applied to the calcaneal tendon owing to how painful it is to have it struck, and how crippling it is to have it severed.
The term was first devised in 1693 by the Dutch anatomist Philip Verheyden, when he was dissecting his own amputated leg.
Role in disease
Achilles tendinitis is inflammation of the tendon, generally due to overuse of the affected limb or as part of a strain injury. Achilles tendon rupture is a partial or complete break in the tendon; it requires immobilisation or surgery. Xanthoma can develop in the Achilles tendon in patients with familial hypercholesterolemia.
Treatment of Achilles' tendon damage
Initial treatment of damage to the tendon is generally nonoperative. Orthotics can produce early relief to the tendon by the correction of malalignments, non-steroidal anti-inflammatory drugs (NSAIDs) are also known to be effective.
Where tendon rupture is concerned, there are three main types of treatment: the open operative method, the percutaneous operative method and nonoperative options.de:Achillessehne eo:Aĥila tendeno ja:アキレス腱 nl:Achillespees pl:Pięta achillesowa
External Links
- Detailed discussion of repair strategies for Achilles' Tendon Rupture (http://rehabilitation.medicalengineer.co.uk/Achilles+Tendon+Repair.php)